Ideology and the Forces of Inefficiency in Government

How frustrating is progressives’ lack of imagination and daring? Things done in the name of some respectable intention harden in their ideology into monuments to their goodness — untouchable and, like art, implicitly impossible to improve.

The question and thought above came to me after reading a letter to the editor by Karen McCurdy of Wakefield, in which the URI department chair takes Gary Sasse to task with an accusation that he wants to make healthcare inaccessible to Americans:

Ironically, Sasse and the GOP propose to limit states’ rights. They want to force states to allow any health insurance company to sell any plan it wants, regardless of quality. This effectively deregulates the health insurance industry, already sitting on millions in profits. Sasse claims this will increase affordability, but that’s only because cheap plans providing minimal benefits will flood into states such as Rhode Island. It will look “affordable” until people try to use it. What if someone has a preexisting condition? Sorry. What if someone wants a 20-something child insured? Forget about it.

Somebody who would write such a paragraph presents a puzzling interlocutor with whom to argue. First one must correct the exaggeration that Republicans are proposing to eliminate all regulation whatsoever. The next obstacle is her assertion that insurers have mountains of cash that government can ply away from them for the benefit of consumers. To the extent that insurers can hold on to excess profits without facing competitors willing to undercut them with lower prices for the reward of slightly smaller lucre hills, it is because mandates prevent competition and hide prices and subsidies fill coffers. Rhode Island, with its meager options, proves this to be so.

Finally a defender of Sasse would have to address the compounding government intervention that becomes necessary when once we set out on a path of poorly conceived policy. If inexpensive, high-deductible plans were available, more people would be able to purchase coverage. This means both that more of us would have coverage before conditions become preexisting and that prices wouldn’t be so high that a 20-something would have to remain a “child” to stay on his or her parents’ plans.

Ramesh Ponnuru spots another example of progressives’ thinking things must continue to be done as progressives originally conceived when it comes to Medicare. Correcting a writer who warned against vouchers in Slate, he points out that “the Congressional Budget Office estimated that the latest version of Ryan’s premium-support idea would generate savings for both the government and Medicare beneficiaries without reducing benefit levels.”

One begins to get the impression that those taking reactionary stands against conservative reforms really don’t want efficiency or trust people with freedom. In the case of a URI professor, the incentive may be largely ideological and tribal, although her six-figure salary in a unionized workforce and state-government-funded benefits package surely provide her a great deal of insulation from the consequences of ObamaCare.

Ideology and peer-group are not the core of such reluctance generally, though, as The American Interestemphasizes while explaining why money-saving reforms like “design-build” contracting for infrastructure jobs face resistance, particularly in blue states:

… unions and groups that benefit from the need to hire additional employees and lawyers to coordinate procurement contracts, change orders, and other issues don’t want a new system that saves money by cutting labor costs.

It pays for people who benefit from massive inefficiency to keep government big and intrusive because they can control and manipulate government to ensure that inefficiency continues to exist.